Der infarktbedingte kardiogene Schock (IKS) ist die schwerste Verlaufsform eines akuten
Koronarsyndroms (ACS), mit sehr hohem Ressourcenverbrauch – insbesondere bei Einsatz
temporärer mechanischer Unterstützungssysteme – und weiterhin sehr hoher Sterblichkeit
zwischen 40 und 50 %. Die Langzeitprognose jedoch ist gut, wenn sowohl die intensivmedizinische
Nachsorge, medikamentöse Therapiemaßnahmen und später auch Lebensstiländerungen greifen.
Abstract
Infarction-related cardiogenic shock is the most severe complication of an acute coronary
syndrome, that still bears a high mortality up to 50 % and wastes a lot of resources
of an intensive care unit, especially if extracorporeal assist devices are used.
In contrast to the adverse short-term outcome, patients fare a surprisingly well in
the long range, both for survival and quality of life. Same as for the acute disease,
which needs specific cardiologic and intensive care measures, long-term follow-up
care needs a lot of medical and lifestyle interventions and treatments to obtain the
best possible result for the patients. Since there is good evidence for cardiologic
therapies from randomized controlled trials, high quality data to treat long-term
sequalae of the stay on intensive care unit, are sparse.
Overall, follow-up care of survivors of infarction related cardiogenic shock includes
the best available treatment of the coronary artery disease, intensified heart failure
therapy of left and right heart dysfunction and evaluation for the risk of sudden
cardiac death and treatment of sequelae of the intensive-care-unit stay.
Schlüsselwörter
infarktbedingter kardiogener Schock - Nachsorge - Herzinsuffizienz-Therapie - kardiovaskuläre
Risikoreduktion
Key words
infarction-related cardiogenic shock - follow up - heart failure - cardiovascular
risk reduction